93 Decision Citation: BVA 93-07923
Y93
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 92-04 486 ) DATE
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THE ISSUE
Entitlement to an increased evaluation for service-connected
neurogenic bladder, currently evaluated as 40 percent
disabling.
REPRESENTATION
Appellant represented by: American Red Cross
ATTORNEY FOR THE BOARD
Christopher P. Kissel, Associate Counsel
INTRODUCTION
The appellant served on active duty from July 1942 to
September 1944, and from January 1951 to April 1952.
In a decision of the Board of Veterans' Appeals (the Board)
dated May 17, 1991, service connection was granted for a
neurogenic bladder disorder. Pursuant to that decision, the
Department of Veterans Affairs Regional Office in Newark,
New Jersey (VARO) assigned a 40 percent disability
evaluation under diagnostic code 7512, by rating action in
September 1991. The appellant was notified of that decision
by letter dated September 24, 1991. He filed a notice of
disagreement on October 15, 1991, and a statement of the
case was issued by VARO on November 12, 1991. The appellant
filed an appeal to the Board on November 18, 1991.
Additional evidence was submitted for VARO's consideration
in February 1992. In a rating decision dated February 27,
1992, VARO confirmed and continued the September 1991 rating
action. A supplemental statement of the case was issued on
March 16, 1992, informing the appellant of that decision.
The appellant's claims folder was forwarded by VARO to the
Board in Washington, D.C., where it was received in April
1992. An informal presentation was prepared by the
appellant's accredited representative, American Red Cross,
and submitted to the Board in July 1992. At that time, his
representative requested that the case be remanded to VARO
for consideration of a total disability evaluation based on
unemployability pursuant to 38 C.F.R. § 4.16(a) (1992), and
for consideration for a clothing allowance pursuant to 38
C.F.R. § 3.810 (1992). The Board refers those issues to
VARO for appropriate development and adjudication.
CONTENTIONS OF APPELLANT ON APPEAL
The appellant contends that his service-connected neurogenic
bladder disorder is of sufficient severity as to warrant an
increased disability rating.
DECISION OF THE BOARD
For the reasons and bases hereinafter set forth, it is the
decision of the Board that appellant's service-connected
neurogenic bladder disorder warrants an increase from the
currently assigned 40 percent disability rating, to 60
percent under diagnostic code 7512.
FINDING OF FACT
The appellant's service-connected neurogenic bladder
disorder is currently manifested by chronic urinal
incontinence requiring daily use of adult diapers.
CONCLUSION OF LAW
The schedular criteria for a 60 percent disability
evaluation for the appellant's service-connected disability
are met. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R.
§§ 3.321, 4.115a, Diagnostic Code 7512 (1992).
REASONS AND BASES FOR FINDING AND CONCLUSION
This section of the Board, in reaching its decision in
accordance with the provisions of 38 U.S.C.A. § 7104 (West
1991), has reviewed and considered all relevant evidence and
material of record incorporated in the appellant's claims
folder and its attachments.
The appellant is seeking a rating in excess of the currently
assigned 40 percent disability rating for his service-
connected neurogenic bladder disorder. 38 C.F.R. Part 4,
Code 7512 (1992).
Initially, the Board finds that the appellant has submitted
evidence which is sufficient to justify a belief that his
claim is well grounded. 38 U.S.C.A. § 5107(a) (West 1991)
and Murphy v. Derwinski, 1 Vet.App. 78 (1990). Furthermore,
we believe that this case has been adequately developed for
appellate purposes by VARO and that we may therefore proceed
to a disposition on the merits.
In evaluating the appellant's request for an increased
rating, the Board considers the medical evidence of record.
The medical findings are compared to the criteria in the VA
Schedule for Rating Disabilities. 38 C.F.R. Part 4 (1992).
In so doing, it is our responsibility to weigh the evidence
before us. Gilbert v. Derwinski, 1 Vet.App. 49 (1990).
Chronic cystitis of a mild degree is noncompensable;
moderate symptoms, pyuria with diurnal and nocturnal
frequency are rated 10 percent disabling; moderately severe
symptoms warrant a 20 percent rating; severe symptoms
consisting of urination at intervals of one hour or less
with contracted bladder are rated 40 percent disabling;
symptoms of urinary incontinence requiring the use of a
protective appliance are rated 60 percent disabling.
38 C.F.R. Part 4, Code 7512 (1992).
The Board has carefully reviewed the pertinent medical
evidence, including the appellant's entire medical history.
38 C.F.R. § 4.1 (1992); Peyton v. Derwinski, 1 Vet.App. 282
(1991).
A VA compensation examination was conducted in February 1992
to evaluate the appellant's service-connected neurogenic
bladder disorder. The appellant described his complaints as
significant for "I am unable to empty my paralyzed bladder
completely (My Dr. prescribed urological catheters to help
empty my bladder). I can not make love or lie next to my
wife because I leak urine. We now sleep in separate beds.
I wet my bed 3-4 times a night because of my uncontrollable
urine leakage, and because of this, I get very little
sleep. My condition has been getting progressively worse."
On genito-urinary examination, the examiner noted a history
of a neurogenic bladder since 1985, and current self-
catheterization, three times per day for the past year. The
examiner noted that the appellant "[a]lways wears diapers,"
and "[n]ow remains incontinent." Diagnosis was
incontinence; and neurogenic bladder, atonic, secondary to
peripheral neuropathy secondary to prolonged Isoniazid (INH)
treatment for pulmonary tuberculosis from 1955 to 1969.
In the opinion of the Board, the disability picture
presented more nearly approximates a 60 percent disability
evaluation under diagnostic code 7512. 38 C.F.R. § 4.7
(1992). The medical evidence of record, contained in the
report of VA examination conducted in February 1992,
indicates that the appellant's bladder disorder is currently
manifested by chronic incontinence requiring daily use of
adult diapers. Based on these findings, we conclude that
the disability picture presented supports a 60 percent
disability evaluation according to the schedular criteria
set forth in diagnostic code 7512.
We have considered the provisions of 38 C.F.R. § 3.321(b)(1)
regarding the assignment of extraschedular evaluations. We
find this provision to be inapplicable to the case before us
because the disability picture is not exceptional or
unusual, with such related factors as marked interference
with employment or frequent periods of hospitalization as to
render impractical the application of the regular schedular
standards.
ORDER
An increased disability rating, to 60 percent for a
neurogenic bladder disorder, is granted, subject to VA
regulations pertaining to the grant of monetary benefits.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
BETTINA S. CALLAWAY MATTHEW J. GORMELY, III
KENNETH R. ANDREWS, JR.
(CONTINUED ON NEXT PAGE)
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West
1991), a decision of the Board of Veterans' Appeals granting
less than the complete benefit, or benefits, sought on
appeal is appealable to the United States Court of Veterans
Appeals within 120 days from the date of mailing of notice
of the decision, provided that a notice of disagreement
concerning an issue which was before the Board was filed
with the agency of original jurisdiction on or after
November 18, 1988 (§ 402 of the Veterans' Judicial Review
Act (Pub. L. 100-687)). The date which appears on the face
of this decision constitutes the date of mailing and the
copy of this decision which you have received is your notice
of the action taken on your appeal by the Board of Veterans'
Appeals.